Filed Under:  Politics

A curious game of chicken over health care and TOPS

16th April 2018   ·   0 Comments

By Christopher Tidmore
Contributing Writer

With less than 50 days left in both the 2018 Regular Session (as well as the promised allotted time for a special session before the fiscal year expires (June 30), the Louisiana Legislature has passed its days—amidst a critical budget crisis with hospitals and TOPS on the line—discussing bills with an impact that even their authors might consider less than urgent.

Passed out of the Senate and heading to the House for debate are SB 253 to allow teachers to join student-led prayer, when there is not one recorded case where educators have been so prohibited (despite a recent ACLU lawsuit); SB 236 to combat bestiality because obviously “sexual abuse against an animal” constitutes an unrecognized major problem in Louisiana; and SB 224 to require the display of “In God We Trust” on every state building—including if the text of the legislation is any indication, every structure including toilets at state parks.

Another bill, HB 531 (taking up hours of floor debate in the House) would remove licensing requirements from florists. No advocate has functionally outlined a major problem in pursuing the flower game when just 25 percent of applicants fail the 40-question floral licensure test on the first try. Admittedly, Louisiana in the only State in the Union mandating licensure for florists, but with a 75 percent passage rate, the issue may not be worth a day of floor debate when a deficit crisis threatens to close most state hospitals.

House Appropriations Commit-tee Chairman Cameron Henry and his GOP allies have held up approval of a budget that would require at least $600 million in tax increases in a promised special session prior to June 30.

The essence of Henry’s argument is that the private operators of the former Charity Hospital system do not need to receive the $150 million in guaranteed state payments. As they are making money, Henry contends, these hospital management groups will not bolt from their operator contracts. Calling the deals struck by former Gov. Bobby Jindal’s administration “a fiasco,” and too

lucrative for private companies, the Appropriations Chairman maintained, “If you’re making money, I can’t expect that you’re going to leave.”

However, the private hospital operators guarantee that they will. They maintain that their revenues are insufficient to justify the contracts without the state subsidy. The New Orleans and Lafayette safety-net hospital managers have formally notified the governor they will return the state-owned facilities and exit their contracts if the worst-case-scenario cuts are enacted. “Zero funding simply makes it fiscally irresponsible. It actually endangers the future of our organization to stay in this agreement,” said David Callecod, president of Lafayette General Hospital.

“If you’re not going to pay them, I think we can all assume that they’re not going to make any money,” Commissioner of Administration Jay Dardenne replied to Henry’s contention. In fact, layoff notices to hospital staff are slated to start going out at the end of the month in Lafayette and several other state hospitals.

Moreover, medical school leaders have warned that closing clinics, and the consequent elimination of inpatient beds and services would render them fewer places to train students—and ultimately even less revenues to run their programs. “We’re very, very concerned. Unless a viable budget is approved … what I can tell you is that it’s going to be catastrophic,” G.E. Ghali, chancellor of LSU Health Sciences Shreveport, told the Senate Finance Committee.

In fact, should the facilities revert back to state control, Louisiana’s budget hole might grow worse, because hospital managers would no longer pay an estimated $168 million next year to lease the facilities. It is a curious game of chicken in Baton Rouge. The GOP House leadership, decrying the budget mess that Republican Governor Bobby Jindal left them with, have dared the private hospital operators to quit. They bet revenues from private patients and Medicaid are too lucrative to give up, despite the operators’ departure promises.

The GOP leadership also wagers that the deficit, which has decreased by at least $300 million thanks to a stronger economy, will constitute enough money to protect the TOPS program—something very popular with the Republican rank-and-file. Still, that gamble presupposes that Democratic Gov. John Bel Edwards will not cut the non-constitutionally guaranteed programs equally—across the board for both higher ed and heath care. They bet that Edwards will not put TOPS on the chopping block as he did last Spring.

The Edwards Administration has promised that it will despite student-body presidents from several universities asked lawmakers to keep higher education financing flat and the TOPS college tuition program whole.

Despite the acrimony, some positive higher educational developments have emerged during this legislative session. Two bills passed the State Senate last week creating two new TOPS awards, rendering students a second chance to receive the popular scholarships—and potentially opening La.’s HBCU students into greater participation in the TOPS program. The bills follow the recommendations by the TOPS Task Force.

SB380 by Democratic Senator Wesley Bishop of New Orleans would open the TOPS scholarship to students who did not qualify for TOPS upon completion of high school but scored at least a 17 on the ACT. In essence the bill would allow that maintaining a decent grade point average in any Louisiana university would qualify students for the TOPS award in subsequent semesters; however, the bill would have another possibility. Very few students at La. HBCUs qualified for TOPS scholarships—as few as just six at SUNO at one point. Most enter college with less than a 20 on their ACTs, a reality which has caused a major funding disparity between historically Black Colleges and Universities like LSU where nearly all incoming freshman have TOPS scholarships. Under Bishop’s bill, the number of HBCU qualifying students might drastically increase with the ACT requirement lowered.

The bill would not take effect until 2021, and the current estimates see just 82 students qualifying, though, that the possibility is that total count could climb drastically if the enacted. (A significant minority of the SUNO student body could eventually qualify). Bishop estimated that his bill would cost about $445,000 in its first year. His bill passed the Senate on a 20-15 vote.

Likewise, Baton Rouge Republican Senator Bodi White proposed an award for community college students who plan to enroll in four-year institutions after earning an associate degree within two years of accepting the award. Currently, 79 students would qualify for this award. White confessed to not knowing what the cost would constitute in the long run. His bill passed the Senate 26-9.

This article originally published in the April 16, 2018 print edition of The Louisiana Weekly newspaper.

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